Our client Mrs. B was initially with another home care agency, she had been with that agency for about 4 months and owed them about $7500 that their long term insurance would not pay to the agency. Mrs. B’s husband was looking for an agency that would be able to fulfill their LTC insurance requirements.
Mrs. B is wheelchair bound and was receiving PT from a local Medicare skilled agency, she needed help with bathing, toileting, exercising and medication management.
During the open process we were able to contact their LTC insurance to find out what the list of requirements would be in order for the LTC to pay for the visits.
Their LTC required a CNA for visits, and after multiple phone calls and attempts we found out the LTC insurance required one skilled RN visit per week in order for the home care portion to be paid.
CareForce Finance Director; Lara worked very hard to stay in contact with the LTC and the client to make sure all the required documents were in place in order for the insurance to pay. After servicing Mrs. B for 5 months and continually staying on top of the insurance Mrs. B received her first insurance reimbursement after 5 months. Mr. B was very appreciative of the help we gave him to navigate the LTC insurance company to finally get the full benefit from the insurance carrier.
Lara has worked with many clients who find the LTC insurance process frustrating. The majority of the time, clients become so frustrated with the process, they give up, and never receive the full benefit of the LTC that they having been paying for years. Lara makes sure that all of our clients know that we will help them throughout the process, sending the LTC the weekly invoices and case notes or any other documents required from the LTC according to their policy.